Yamagata, K., Arai, C., Sasaki, H., Takeuchi, Y., Onizawa, K., Yanagawa, T., … Bukawa, H. (2012). The effect of oral management on the severity of oral mucositis during hematopoietic SCT. Bone Marrow Transplantation, 47, 725–730.doi: 10.1038/bmt.2011.171
To determine the effectiveness of an oral management program in reducing oral mucositis (OM) incidence and severity in patients undergoing stem cell transplant (SCT)
Patients undergoing hematopoietic SCT were retrospectively enrolled in a study to determine if the occurrence and severity of OM was significantly different between a group of patients who received appropriate oral management and those who did not. The control group underwent SCT in 2007–2008, and the oral management group in 2009. This study included an oral evaluation, from the same oral health professionals, for all 48 enrollees prior to SCT. All serious dental issues (e.g., periodontitis, tooth extraction) were treated prior to starting SCT. Patients in the oral management group received oral care instruction with the transplant team prior to SCT. They also received an additional oral exam from the dentist and hygienist as well as instructions (including tooth brushing and oral swab use), based on their OM status. Both groups were treated with the same medications, based on the same OM toxicity scale, as graded by trained SCT nurses. OM in both groups was treated with azulene sodium sulfate and 4% lidocaine rinse.
This was a single-site inpatient study conducted at the Tsukuba University Hospital in Tsukuba, Japan.
Patients were undergoing the active antitumor treatment phase of care.
This was an observational, two-group trial.
OM was graded using the National Cancer Institute's (NCI’s) Common Terminology Criteria for Adverse Events (CTCAE, version 3.0).
Oral management was associated with lower incidence of OM and lower average severity of mucositis in patients undergoing HCT.
With this study’s evidence, nurses can educate patients and reinforce continued oral care at home as well as recommend dental evaluation prior to starting chemotherapy for patients with oral health issues. These measures should help to reduce oral side effects and reassure patients that they have some control over disease management.